In the late 1980s, a new technique was proposed that would revolutionize radiotherapy. Now referred to as intensity-modulated radiotherapy, it is at the core of state-of-the-art photon beam delivery techniques, such as helical tomotherapy and volumetric modulated arc therapy. Despite over two decades of clinical application, there are still no established guidelines on the calibration of dynamic modulated photon beams. In 2008, the IAEA-AAPM work group on nonstandard photon beam dosimetry published a formalism to support the development of a new generation of protocols applicable to nonstandard beam reference dosimetry (Alfonso et al 2008 Med. Phys. 35 5179–86). The recent IAEA Code of Practice TRS-483 was published as a result of this initiative and addresses exclusively small static beams. But the plan-class specific reference calibration route proposed by Alfonso et al (2008 Med. Phys. 35 5179–86) is a change of paradigm that is yet to be implemented in radiotherapy clinics. The main goals of this paper are to provide a literature review on the dosimetry of nonstandard photon beams, including dynamic deliveries, and to discuss anticipated benefits and challenges in a future implementation of the IAEA-AAPM formalism on dynamic photon beams.

在 1980 年代后期，提出了一种新技术，它将彻底改变放射治疗。现在被称为调强放射疗法，它是最先进的光子束传输技术的核心，例如螺旋断层疗法和体积调制弧线疗法。尽管临床应用已有二十多年，但仍然没有关于动态调制光子束校准的既定指南。2008 年，IAEA-AAPM 非标准光子束剂量学工作组发布了一种形式，以支持开发适用于非标准束参考剂量学的新一代协议（Alfonso et al 2008 Med. Phys. 355179-86）。最近的 IAEA 实践守则 TRS-483 是该倡议的结果，专门针对小型静态光束。但是 Alfonso等人(2008 Med. Phys. 35 5179–86)提出的计划级特定参考校准路线是一种尚未在放射治疗诊所实施的范式变化。本文的主要目标是对非标准光子束的剂量学（包括动态传递）进行文献综述，并讨论在未来实施 IAEA-AAPM 动态光子束形式时的预期收益和挑战。